In the summer of 2020, Beth and Alex Korth learned that Beth was pregnant with their first child. What was supposed to be a moment of joy for the Korths was tempered by the nagging uncertainty of the months that lay ahead. No pregnancy is a sure thing. And there’s always a natural fear of the unknown, especially for first-time parents. But the Korths had to live with the added insecurity of knowing in advance that Beth’s was among the 62 percent of pregnancies that, for whatever reason, are considered high-risk. 

In Beth and Alex’s case, both soon-to-be parents were born with achondroplasia, otherwise known as dwarfism. Because both Korths had the bone growth disorder, there was a 25 percent chance that their baby would have a severe form of it and would die shortly after birth.

Staff built a special bassinet for 3’10” Beth and 4’4” Alex Korth, so they could reach their baby, Everett. LUCYUS FEVRIER/TUFTS MEDICAL

Knowing the stakes were that much higher, the Korths had to choose their child’s birthplace carefully. It had to be a hospital with the expertise, experience, and technology to handle a potentially problematic pregnancy and delivery. But more than anything, they wanted doctors and nurses who were compassionate and would do everything they could to ensure a pleasant experience and a positive outcome for mother and child alike. Based on these criteria and a recommendation from Beth’s mentor, the Korths chose the high-risk pregnancy team at Tufts Medical Center.

“The Tufts Medical Center team was so flexible and helpful,” says Beth. “They really listened to my suggestions to allay my fears and enhance my hospital experience.”

While the Korths’ case is relatively rare, there are many other scenarios for families, from expecting twins or triplets to a family history of genetic conditions to the mother having a heart condition to a history of complicated pregnancies that can categorize a pregnancy as high risk. 

One of the most common high-risk scenarios is women who become pregnant at age 35 or older. According to the Centers for Disease Control and Prevention, delaying childbirth is becoming increasingly popular, particularly among women ages 35 to 39. Whether busy building their careers or trying to find the right partner, more and more women are waiting to have a family, even into their 40s — and that decision comes with some risks.

“Even if you get pregnant, the risk of miscarriage increases with age,” says Dr. Britta Panda, a perinatologist at Tufts Medical Center. “The risk of losing the pregnancy in the first trimester is 15 percent at 30-34 years of age, 25 percent at 35-39, and 50 percent at 40-44.”

Expectant women over age 35 also face an increased likelihood of complications during their pregnancy. They are at greater risk of developing conditions, such as gestational diabetes and preeclampsia. They are more likely to deliver by cesarean section (C-section) and have babies with chromosomal disorders. The chances of having a child with Down Syndrome, for instance, is 1 in 950 at age 30, 1 in 370 at age 35, and 1 in 105 at the age of 40.

No matter the situation, the key to a positive experience and an optimal outcome with any high-risk pregnancy is laying out a plan ahead of time. That preparation should actually begin years before you decide to start your family. If, for instance, you plan on having children after age 35, you should take steps to optimize your health in order to eliminate additional risk factors. This includes losing extra weight, exercising to keep in shape, eating healthy to gain necessary nutrients, and consulting with your doctor to address chronic issues like thyroid problems, diabetes, and hypertension.

“First and foremost, it’s important to come up with a plan around age 30,” says Dr. Panda. “Begin with determining whether you even want to have kids, and if so, when would be the right time for you.”

Once you’ve decided when to start trying to get pregnant, the next major decision is to choose where you want to have your baby. Then the real planning begins. For instance, at Tufts Medical Center, the high-risk pregnancy team applies a comprehensive approach to every aspect of prenatal care, delivery and post-natal care. This includes input from experts in a wide variety of specialties, including maternal-fetal medicine, newborn medicine, cardiology, interventional cardiology, anesthesiology and nursing.

And when the big day arrives, the Tufts MC team knows exactly how to proceed, complete with contingencies for any unforeseen complications, in order to ensure a healthy mother and child. As well as a Level III Neonatal Intensive Care Unit (NICU) if your baby were to need advanced care.

“My doctors at Tufts MC had a plan for an achondroplasia delivery that made me feel so comfortable,” says Beth Korth. “They took it slow in the OR and explained everything every step of the way.”

For the Korths, the pregnancy went smoothly. On the scheduled day, Dr. Panda performed the C-section and Beth gave birth to a healthy baby boy, Everett. The child does not have achondroplasia and will grow to be average height—an outcome that occurs in just 25 percent of such births. After the successful delivery, the Korths were given a room in the Tufts MC Mother-Infant Unit specifically tailored to their needs, including a custom-made bassinet that was the right height to allow Beth and Alex to easily pick up and hold their infant son. 

“I cannot speak more highly of the doctors, nurses, and staff at Tufts Medical Center,” says Beth. “Everyone always seemed like they were watching out for us. They gave us peace of mind.”

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